ABSTRACT
A 48-year-old man presented with a two-year history of a generalized, pruritic eruption that was associated with numerous, dome-shaped papules and nodulocystic lesions. Biopsy specimens have shown keratoacanthomas and a lichenoid dermatitis. Evaluation for malignant conditions has been negative. Owing to the constellation of findings, a diagnosis of generalized eruptive keratoacanthomas of Grzybowski associated with lichenoid dermatitis and acneiform lesions is favored. The patient is currently on a trial of acitretin.
Subject(s)
Keratoacanthoma/pathology , Skin Diseases/pathology , Humans , Male , Middle AgedABSTRACT
54-year-old woman presented with an unusual presentation of chronic cutaneous lupus erythematosus that mimicked pseudoxanthoma elasticum. The lesions were asymptomatic, 2-3 mm, skin-colored, smooth papules without scale or erythema; they were located on the chin, medial malar cheeks, and upper lip. She previously failed traditional treatments, which included hydroxychloroquine and dapsone. The patient responded to thalidomide with a reduction in appearance and number of lesions.
Subject(s)
Facial Dermatoses/pathology , Lupus Erythematosus, Discoid/pathology , Pseudoxanthoma Elasticum/diagnosis , Facial Dermatoses/diagnosis , Female , Heroin , Humans , Lupus Erythematosus, Discoid/diagnosis , Lupus Erythematosus, Discoid/drug therapy , Middle AgedABSTRACT
A 45-year-old woman presented with multiple, small, asymptomatic, hyperpigmented to skin-colored, smooth, dermal papules on the right temple as well as with uterine fibroids. She has a family history of uterine fibroids and cutaneous leiomyomas. An autosomal dominant disorder of multiple cutaneous leiomyomas and uterine fibroids (Reed syndrome) has been localized to a gene on chromosome 1q42.3-43. This gene encodes fumarate hydratase, which is an enzyme in the Kreb cycle, that acts as a tumor suppressor in this familial disorder. A subset of people may be at risk for papillary renal cell carcinoma.
Subject(s)
Leiomyomatosis/genetics , Skin Neoplasms/genetics , Uterine Neoplasms/genetics , Female , Humans , Leiomyomatosis/diagnosis , Middle Aged , Skin Neoplasms/diagnosisABSTRACT
A 26-year-old woman with tuberous sclerosis complex had numerous cutaneous manifestations and systemic manifestations that included subependymal nodules, pulmonary lymphangioleiomyomatosis, renal cysts, and bilateral renal angiomyolipomas. Tuberous sclerosis is a hamartomatous disease with defects in either hamartin (TSC1) or tuberin (TSC2) that can be of autosomal dominant inheritance or spontaneous mutation.
Subject(s)
Skin Diseases/diagnosis , Tuberous Sclerosis/diagnosis , Adult , Female , HumansABSTRACT
A 49-year-old man presented with nodules on his right hand after a history of Mycobacterium marinum infection recently treated with rifampin and clarithromycin. The patient has an aquarium with Betta fish (Siamese fighting fish).
Subject(s)
Hand Dermatoses/diagnosis , Hand Dermatoses/microbiology , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium marinum , Humans , Male , Middle AgedABSTRACT
A 20-year-old woman presented with an asymptomatic, life-long, verrucous, hyperpigmented plaque on the face and neck that corresponded to the lines of Blaschko. Histopathologic examination shows an epidermal nevus. This nevus presents a challenge in management because of the location and extent of the lesion.
Subject(s)
Facial Neoplasms , Nevus , Skin Neoplasms , Adult , Facial Neoplasms/pathology , Facial Neoplasms/therapy , Female , Humans , Nevus/pathology , Nevus/therapy , Skin Neoplasms/pathology , Skin Neoplasms/therapyABSTRACT
IL-10 is a pleiotropic cytokine that inhibits several immune parameters, including Th1 cell-mediated immune responses, antigen presentation, and antigen-specific T cell proliferation. Recent data implicate IL-10 as a mediator of suppression of cell-mediated immunity induced by exposure to UVB radiation (280-320 nm). To investigate the effects of IL-10 on the cutaneous immune system, we engineered transgenic mice that overexpress viral IL-10 (vIL-10) in the epidermis. vIL-10 transgenic mice demonstrated a reduced number of I-A(+) epidermal and dermal cells and fewer I-A(+) hapten-bearing cells in regional lymph nodes after hapten painting of the skin. Reduced CD80 and CD86 expression by I-A(+) epidermal cells was also observed. vIL-10 transgenic mice demonstrated a smaller delayed-type hypersensitivity response to allogeneic cells upon challenge but had normal contact hypersensitivity to an epicutaneously applied hapten. Fresh epidermal cells from vIL-10 transgenic mice showed a decreased ability to stimulate allogeneic T cell proliferation, as did splenocytes. Additionally, chronic exposure of mice to UVB radiation led to the development of fewer skin tumors in vIL-10 mice than in WT controls, and vIL-10 transgenic mice had increased splenic NK cell activity against YAC-1targets. These findings support the concept that IL-10 is an important regulator of cutaneous immune function.
